Acute Pericarditis | Lessons with Audio and Video | #106

This is an example of acute pericarditis as auscultated at Erb's Point. Murmurs are caused by turbulent blood flow across incompetent or stenotic valves. In contrast, a pericardial friction rub is caused by the rubbing together of two surfaces of the pericardial sack. The pericardial friction rub has three parts; a systolic component, an early diastolic component and a late diastolic component. The first and second heart sounds are obscured by the rubbing sounds. In the anatomy video you can see the yellow fluid accumulation around the heart caused by an inflamed pericardial sack.

Auscultation Sounds

Patient Recording

Patient Recording - Half Speed

Position

The patient's position should be sitting leaning forward.

Listening Tips

S1:Rubbing, scratchy sound
Systole:Rubbing, scratchy sound, usually loudest during systole
S2:Rubbing, scratchy sound
Diastole:Rubbing, scratchy sound

Waveform (Phonocardiogram)

Observe Cardiac Animation

Review the cardiac animation and notice the yellow fluid accumulation around the heart caused by an inflamed pericardial sack.

Authors and Sources

Authors and Reviewers

EKG heart rhythm modules: Thomas O'Brien.
EKG monitor simulation developer: Steve Collmann
12 Lead Course: Dr. Michael Mazzini, MD.
Spanish language EKG: Breena R. Taira, MD, MPH
Medical review: Dr. Jonathan Keroes, MD
Heart sounds and mentorship: W. Proctor Harvey, MD
Medical review: Dr. Pedro Azevedo, MD, Cardiology
Last Update: 1/8/2023

Sources

Electrocardiography for Healthcare Professionals, 5th Edition Kathryn Booth and Thomas O'Brien
ISBN10: 1260064778, ISBN13: 9781260064773
McGraw Hill, 2019
Rapid Interpretation of EKG's, Sixth Edition
Dale Dublin
Cover Publishing Company
12 Lead EKG for Nurses: Simple Steps to Interpret Rhythms, Arrhythmias, Blocks, Hypertrophy, Infarcts, & Cardiac Drugs
Aaron Reed
Create Space Independent Publishing
Heart Sounds and Murmurs: A Practical Guide with Audio CD-ROM 3rd Edition
Elsevier-Health Sciences Division
Barbara A. Erickson, PhD, RN, CCRN
Clinical Heart Disease W Proctor Harvey, MD
Clinical Heart Disease
Laennec Publishing; 1st edition (January 1, 2009)
The Virtual Cardiac Patient: A Multimedia Guide to Heart Sounds, Murmurs, EKG Jonathan Keroes, David Lieberman
Publisher: Lippincott Williams & Wilkin)
ISBN-10: 0781784425; ISBN-13: 978-0781784429
Project Semilla, UCLA Emergency Medicine, EKG Training Breena R. Taira, MD, MPH

Return to Reference Guide Index Page

Acute Pericarditis | Lessons with Audio and Video | #106